What symptoms or effects does omicron cause in children?
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(CNN) --
Although the omicron variant of the coronavirus may have a reputation for causing a much milder form of Covid-19, in January, Dr. Ashley Keilman and other doctors began noticing something that seemed unique to this variant.
"We were seeing more patients with croup and more patients testing positive for COVID, something we hadn't seen during previous phases of COVID waves," said Keilman, a pediatric emergency medicine specialist at Seattle Children's Hospital.
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And it's not unique to Seattle.
Pediatricians across the country say they are seeing an increase in cases of croup, also known as laryngotracheobronchitis.
Croup is usually caused by parainfluenza respiratory viruses.
It occurs when the upper airways become inflamed, making it difficult to breathe.
Since children's airways are smaller than those of adults, it is more common among toddlers.
This inflammation in the larynx, trachea, and bronchial tubes causes children to have a distinctive, loud cough that some say sounds like a barking seal.
When the child tries to breathe, they may also produce a high-pitched whistling sound known as stridor.
In some cases, the symptoms may go away after about five days.
But for other children, the symptoms don't go away with home treatments.
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Keilman is the author of a preprint-stage study, which means it has not been peer-reviewed or published in a journal, which found that a total of 401 children seen in the ER were diagnosed with croup during the delta variant outbreak and 107 during the wave of omicron.
Croup patients during the omicron surge were more likely to test positive for covid-19: 2.8% of croup cases tested positive during the delta surge, versus 48.2% during the omicron surge .
"The omicron variant has been shown to be a disease of the upper airways rather than the lower airways in the lungs and so people write it off as just a cold and it's not a big deal. But I think what we recorded is that of the upper respiratory infections, of the viral infections, croup is one of the most serious and puts children in the ICU on a regular basis," said study co-author Dr. Indi Trehan, a physician at infectious diseases, virology, and emergency medicine at Seattle Children's Hospital.
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"As any parent will tell you, it's one of the scariest things to see your child not being able to breathe because of it," Trehan added.
"So this early signal of high rates of croup with omicron is quite concerning. We are trying to get this news out to our colleagues."
Other doctors across the country have told him they have seen similar trends.
Another preliminary study found that 2.4% of children aged 13 or younger who were hospitalized in an area of South Africa for covid-19 caused by the omicron variant also had a diagnosis of croup.
There has also been more opportunity for croup to develop with this surge because so many children have been infected with covid-19.
Since early January, nearly 4.2 million cases of COVID-19 have been reported in American children, according to the American Academy of Pediatrics.
Dr. Claudia Hoyen, a pediatric infectious disease specialist at Rainbow Babies and Children's University Hospital in Cleveland, who did not collaborate with these studies, said croup season in her area usually comes in the fall.
So when more kids with croup started showing up in December, during the omicron surge, she suspected there was something different about this variant.
"We know that the nasal tissues are much more receptive to omicron, and the lung is not," Hoyen said.
"We haven't seen croup with other waves. This one was different."
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Hoyen and doctors at Seattle Children's Hospital said that, fortunately, most children with croup have not needed to be admitted to the hospital.
If they are admitted for treatment, doctors often give them a corticosteroid that can reduce airway inflammation.
Even better than a corticosteroid, doctors say, is that kids don't get Covid-19 in the first place.
Since little ones, who most often get croup, still can't be vaccinated, Hoyen says, it would be best to make sure everyone around them is fully vaccinated, if possible.
"Do what you can to keep the little ones from being a barking seal. It's really distressing to listen to, believe me, and it can be pretty serious," Hoyen said.
"So do what you can to help them. Getting vaccinated is easy and important."
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